Painless thyroiditis may be followed by
recurrent hyperthyroidism in patients with Graves’ disease
(March 2004)
The background of the study.
Thyroid inflammation may cause or be caused by autoimmune thyroid
disease. In this study, patients with painless thyroiditis were
followed to determine if their thyroid inflammation led to the onset
or recurrence of hyperthyroidism caused by Graves’ disease.
How the study was done.
The study group consisted of 92 patients with painless thyroiditis
(transient hyperthyroidism and thyroid enlargement, with a low thyroid
radioiodine uptake). Forty of them had a history of Graves’
hyperthyroidism and were in remission after prolonged antithyroid
drug therapy; they had onset of painless thyroiditis 4 to 122 months
after the therapy was stopped. The other 52 patients with painless
thyroiditis had no history of Graves’ disease. All the patients
were followed for at least six months after the onset of painless
thyroiditis.
The results of the study.
Seven of the 40 patients (18 percent) who had a history of Graves’
hyperthyroidism had recurrent hyperthyroidism 8 to 10 weeks after
the onset of painless thyroiditis. At the onset of painless thyroiditis,
these seven patients had more thyrotropin (TSH)-receptor antibodies
in their serum than did the 33 patients who did not have recurrent
hyperthyroidism. No patient in the group who had no history of Graves’
hyperthyroidism had the onset of hyperthyroidism during follow-up.
The conclusions of the study.
Patients with Graves’ hyperthyroidism in remission after being
treated with an antithyroid drug may have a recurrence of hyperthyroidism
after an episode of painless thyroiditis.
The original article.
Iitaka M, Morgenthaler NG, Momotani N, Nagata A, Ishikawa N, Ito
K, Katayama S, Ito K. Stimulation of thyroid-stimulating hormone
(TSH) receptor antibody production following painless thyroiditis.
Clin Endocrinol (Oxf) 2004;60:49-53.
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